A Manganese Alternative to Gadolinium for MRI Contrast

The Transition from Metal-Based to Metal-Free Contrast Agents for T1 Magnetic Resonance Imaging Enhancement

Magnetic resonance imaging (MRI) has received significant attention as the noninvasive diagnostic technique for complex diseases. Image-guided therapeutic strategy for diseases such as cancer has also been at the front line of biomedical research, thanks to the innovative MRI, enhanced by the prior delivery of contrast agents (CAs) into patients' bodies through injection. These CAs have contributed a great deal to the clinical utility of MRI but have been based on metal-containing compounds such as gadolinium, manganese, and iron oxide. Some of these CAs have led to cytotoxicities such as the incurable Nephrogenic Systemic Fibrosis (NSF), resulting in their removal from the market. On the other hand, CAs based on organic nitroxide radicals, by virtue of their structural composition, are metal free and without the aforementioned drawbacks. They also have improved biocompatibility, ease of functionalization, and long blood circulation times, and have been proven to offer tissue contrast enhancement with longitudinal relaxivities comparable with those for the metal-containing CAs. Thus, this Review highlights the recent progress in metal-based CAs and their shortcomings. In addition, the remarkable goals achieved by the organic nitroxide radical CAs in the enhancement of MR images have also been discussed extensively. The focal point of this Review is to emphasize or demonstrate the crucial need for transition into the use of organic nitroxide radicals-metal-free CAs-as against the metal-containing CAs, with the aim of achieving safer application of MRI for early disease diagnosis and image-guided therapy.

Accurate identification of myocardial viability after myocardial infarction with novel manganese chelate-based MR imaging

We developed a novel manganese (Mn²⁺ ) chelate for magnetic resonance imaging (MRI) assessment of myocardial viability in acute and chronic myocardial infarct (MI) models, and compared it with Gadolinium-based delay enhancement MRI (Gd³⁺ -DEMRI) and histology. MI was induced in 14 rabbits by permanent occlusion of the left circumflex coronary artery. Gd³⁺ -DEMRI and Mn²⁺ chelate-based delayed enhancement MRI (Mn²⁺ chelate-DEMRI) were performed at 7 days (acute MI, n = 8) or 8 weeks (chronic MI, n = 6) after surgery with sequential injection of 0.15 mmol/kg Gd³⁺ and Mn²⁺ chelate. The biodistribution of Mn²⁺ in tissues and blood was measured at 1.5 and 24 h. Blood pressure, heart rate (HR), left ventricular (LV) function, and infarct fraction (IF) were analyzed, and IF was compared with the histology. The Mn²⁺ chelate group maintained a stable hemodynamic status during experiment. For acute and chronic MI, all rabbits survived without significant differences in HR or LV function before and after injection of Mn²⁺ chelate or Gd³⁺ (p > 0.05). Mn²⁺ chelate mainly accumulated in the kidney, liver, spleen, and heart at 1.5 h, with low tissue uptake and urine residue at 24 h after injection. In the acute MI group, there was no significant difference in IF between Mn²⁺ chelate-DEMRI and histology (22.92 ± 2.21% vs. 21.79 ± 2.25%, respectively, p = 0.87), while Gd³⁺ -DEMRI overestimated IF, as compared with histology (24.54 ± 1.73%, p = 0.04). In the chronic MI group, there was no significant difference in IF between the Mn²⁺ chelate-DEMRI, Gd³⁺ -DEMRI, and histology (29.50 ± 11.39%, 29.95 ± 9.40%, and 29.00 ± 10.44%, respectively, p > 0.05), and all three were well correlated (r = 0.92-0.96, p < 0.01). We conclude that the use of Mn²⁺ chelate-DEMRI is reliable for MI visualization and identifies acute MI more accurately than Gd³⁺ -DEMRI.

Mn(II) compounds as an alternative to Gd-based MRI probes

Mn(II) has several favorable physicochemical characteristics and a good toxicity profile, which makes it a viable alternative to the Gd(III)-based MRI contrast agents currently used in clinics. Although many studies have been undertaken in the last 10 years, this is a field of investigation still in rapid and continuous development. This review aims to critically discuss the chemical and magnetic properties of Mn(II) compounds relevant as MRI probes, both small complexes and nanosystems containing a large number of metal centers, the possible approaches for optimizing their efficiency by understanding the role of various molecular parameters that control the relaxation processes, and the most important issues related to stability and kinetic inertness.

Minimally invasive manganese-enhanced magnetic resonance imaging for the sciatic nerve tract tracing used intra-articularly administrated dextran-manganese encapsulated nanogels

Manganese-enhanced magnetic resonance imaging (MEMRI) enables tract tracing to follow neural pathways through axonal transport. However, the method is problematic because of the high local concentrations of Mn2+ involved. We developed a tetrananogel containing a dextran-manganese complex (Dex-Mn-Gel) and applied this nanogel to rats. MnCl2 (n = 5), Dex-Mn-Gel (n = 5), or saline control (n = 3) was injected into the left knee joint of the rats (n = 13). Inflammation and tissue alterations in the knee joint were also evaluated histologically. T1-weighted images were obtained on a 7 T MRI system 24 hours after the administration and compared across groups. The sciatic nerve in both legs and the surrounding musculature were used as regions of interest (ROI). No swelling was found in the knee joint infused with Dex-Mn-Gel, although prominent swelling of the knee joint was observed with MnCl2. White blood cells inside the knee joint tissue infused with the Dex-Mn-Gel were significantly less abundant (45%, P < .05) compared with the knee joints infused with MnCl2. Visualization of the sciatic nerve was significantly enhanced in rats treated with both forms of Mn2+ compared with controls (P < .01). This study is the first to attempt intra-articular administration of a manganese contrast agent into joint-capsule and demonstrate tract visualization. The Dex-Mn-Gel can be taken up by the nerve endings and reduce Mn2+ toxicity. Dex-Mn-Gel will provide a minimally invasive method for visualizing nerve tracts in vivo.

Paramagnetic Clusters of Mn3(O2CCH3)6(Bpy)2 in Polyacrylamide Nanobeads as a New Design Approach to a T1- T2 Multimodal Magnetic Resonance Imaging Contrast Agent

There is an increasing need for gadolinium-free magnetic resonance imaging (MRI) contrast agents, particularly for patients suffering from chronic kidney disease. Using a cluster-nanocarrier combination, we have identified a novel approach to the design of biomedical nanomaterials and report here the criteria for the cluster and the nanocarrier and the advantages of this combination. We have investigated the relaxivity of the following manganese oxo clusters: the parent cluster Mn₃(O₂CCH₃)₆(Bpy)₂ (1) where Bpy = 2,2'-bipyridine and three new analogs, Mn₃(O₂CC₆H₄CH═CH₂)₆(Bpy)₂ (2), Mn₃(O₂CC(CH₃)═CH₂)₆(Bpy)₂ (3), and Mn₃O(O₂CCH₃)₆(Pyr)₂ (4) where Pyr = pyridine. The parent cluster, Mn₃(O₂CCH₃)₆(Bpy)₂ (1), had impressive relaxivity ( r₁ = 6.9 mM^-1 s^-1, r₂ = 125 mM^-1 s^-1) and was found to be the most amenable for the synthesis of cluster-nanocarrier nanobeads. Using the inverse miniemulsion polymerization technique (1) in combination with the hydrophilic monomer acrylamide, we synthesized nanobeads (∼125 nm diameter) with homogeneously dispersed clusters within the polyacrylamide matrix (termed Mn₃Bpy-PAm). The nanobeads were surface-modified by co-polymerization with an amine-functionalized monomer. This enabled various postsynthetic modifications, for example, to attach a near-IR dye, Cyanine7, as well as a targeting agent. When evaluated as a potential multimodal MRI contrast agent, high relaxivity and contrast were observed with r₁ = 54.4 mM^-1 s^-1 and r₂ = 144 mM^-1 s^-1, surpassing T₁ relaxivity of clinically used Gd-DTPA chelates as well as comparable T₂ relaxivity to iron oxide microspheres. Physicochemical properties, cellular uptake, and impacts on cell viability were also investigated.

Host-Guest Chemistry in Supramolecular Theranostics

Macrocyclic hosts, such as cyclodextrins, calixarenes, cucurbiturils, and pillararenes, exhibit unparalleled advantages in disease diagnosis and therapy over the past years by fully taking advantage of their host-guest molecular recognitions. The dynamic nature of the non-covalent interactions and selective host-guest complexation endow the resultant nanomaterials with intriguing properties, holding promising potentials in theranostic fields. Interestingly, the differences in microenvironment between the abnormal and normal cells/tissues can be employed as the stimuli to modulate the host-guest interactions, realizing the purpose of precise diagnosis and specific delivery of drugs to lesion sites. In this review, we summarize the progress of supramolecular theranostics on the basis of host-guest chemistry benefiting from their fantastic topological structures and outstanding supramolecular chemistry. These state-of-the-art examples provide new methodologies to overcome the obstacles faced by the traditional theranostic systems, promoting their clinical translations.

Construction of Paramagnetic Manganese-Chelated Polymeric Nanoparticles Using Pyrene-End-Modified Double-Hydrophilic Block Copolymers for Enhanced Magnetic Resonance Relaxivity: A Comparative Study with Cisplatin Pharmacophore

Cationic metal-mediated self-assembly of double-hydrophilic block copolymers (DHBCs) has been of great interest for the preparation of hybrid nanoparticles for versatile applications. Among many functional transition-metal ions, manganese (Mn^II) is a highly attractive element due to its paramagnetic property with a high coordination number. However, Mn^II does not lead to the efficient self-assembly of DHBCs because of the relatively high aqueous solubility of coordinated Mn^II. This article reports a facile method for direct conjugation of Mn^II ions inside sterically stabilized polymer assemblies, composed of pyrene-end-modified DHBCs. Nitroxide-mediated radical polymerization was used to prepare the poly(ethylene glycol)- b-poly(acrylate) DHBC precursor, followed by the end-modification with pyrene maleimide via the radical-exchange reaction. Employing the self-associated DHBC as the nanoscale template, the simple addition of Mn^II enables a large number of polyvalent Mn^II ions to be immobilized at the chelating blocks of DHBCs, which can be readily monitored by the excimeric fluorescence emission change of the terminal pyrene fluorophore. The resulting Mn^II-loaded polymeric nanoparticles (Mn^II-PNPs) possess nanogel-like scaffolds, which allow for efficient water permeation at the Mn^II-incorporated interior for enhanced magnetic resonance contrasting effect. Additionally, by comparing the coordination properties of Mn^II and cisplatin, we endeavor to understand the internal structures and the relevant physicochemical features of metal-chelated nanoparticles.

Nanoparticle-Based Paramagnetic Contrast Agents for Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a noninvasive medical imaging modality that is routinely used in clinics, providing anatomical information with micron resolution, soft tissue contrast, and deep penetration. Exogenous contrast agents increase image contrast by shortening longitudinal (T 1) and transversal (T 2) relaxation times. Most of the T 1 agents used in clinical MRI are based on paramagnetic lanthanide complexes (largely Gd-based). In moving to translatable formats of reduced toxicity, greater chemical stability, longer circulation times, higher contrast, more controlled functionalisation and additional imaging modalities, considerable effort has been applied to the development of nanoparticles bearing paramagnetic ions. This review summarises the most relevant examples in the synthesis and biomedical applications of paramagnetic nanoparticles as contrast agents for MRI and multimodal imaging. It includes the most recent developments in the field of production of agents with high relaxivities, which are key for effective contrast enhancement, exemplified through clinically relevant examples.

Molecular Magnetic Resonance Imaging Using a Redox-Active Iron Complex

We introduce a redox-active iron complex, Fe-PyC3A, as a biochemically responsive MRI contrast agent. Switching between Fe3+-PyC3A and Fe2+-PyC3A yields a full order of magnitude relaxivity change that is field-independent between 1.4 and 11.7 T. The oxidation of Fe2+-PyC3A to Fe3+-PyC3A by hydrogen peroxide is very rapid, and we capitalized on this behavior for the molecular imaging of acute inflammation, which is characterized by elevated levels of reactive oxygen species.  Injection of Fe2+-PyC3A generates strong, selective contrast enhancement of inflamed pancreatic tissue in a mouse model (caerulein/LPS model). No significant signal enhancement is observed in normal pancreatic tissue (saline-treated mice). Importantly, signal enhancement of the inflamed pancreas correlates strongly and significantly with ex vivo quantitation of the pro-inflammatory biomarker myeloperoxidase. This is the first example of using metal ion redox for the MR imaging of pathologic change in vivo. Redox-active Fe3+/2+ complexes represent a new design paradigm for biochemically responsive MRI contrast agents.

Summary of Imaging in 2020: Visualizing the Future of Healthcare with MR Imaging

The Imaging in 2020 meeting convenes biannually to discuss innovations in medical imaging. The 2018 meeting, titled "Visualizing the Future of Healthcare with MR Imaging," sought to encourage discussions of the future goals of MRI research, feature important discoveries, and foster scientific discourse between scientists from a variety of fields of expertise. Here, we highlight presented research and resulting discussions of the meeting.

Controlling water exchange rates in potential Mn2+-based MRI agents derived from NO2A2

We report a series of pentadentate ligands based on a 1,4,7-triazacyclononane-1,4-diacetic acid (H2NO2A) containing different substituents attached to the third nitrogen atom of the macrocyclic unit. Detailed 1H Nuclear Magnetic Relaxation Dispersion (NMRD) characterisation of the corresponding Mn2+ complexes suggests the formation of six-coordinate species in solution containing an inner-sphere water molecule. This was confirmed by recording the transverse 17O relaxation time and chemical shift measurements. The water exchange rate of the coordinated water molecule was found to be strongly influenced by the nature of the substituent R at position 7 of the triazacyclononane unit (R = Me, k298ex = 62.6 × 107 s-1; R = Bz, k298ex = 4.4 × 107 s-1; R = 1-phenylethyl, k298ex = 2.6 × 107 s-1). The decreasing exchange rates are explained by the increasing bulkiness of the substituent, which hinders the approach of the entering water molecule in an associatively activated water exchange mechanism. This is supported by DFT calculations (M062X/TZVP), which confirm the associative nature of the water exchange reaction. A potentially decadentate ligand containing two NO2A units linked by a xylenyl spacer in the meta position was also synthesised. The corresponding binuclear Mn2+ complex contains two metal ions with different hydration numbers, as evidenced by 1H NMRD and 17O NMR measurements. DFT calculations show that this is related to the presence of a bridging bidentate μ-η1-carboxylate group connecting the two metal centers. The results reported in this work provide a straightforward strategy to control the exchange rate of the coordinated water molecule in this family of MRI contrast agent candidates.

Gadolinium Deposition in Neurology Clinical Practice

Background: Magnetic resonance imaging (MRI) enhanced with gadolinium-based contrast agents (GBCAs) is an essential tool in the diagnosis and management of many neurologic diseases, including multiple sclerosis, brain tumors, and infections. The clinical utility of GBCAs is evidenced by their widespread use. GBCAs are produced in macrocyclic and linear forms. Since 2014, evidence has suggested that repeated administration of GBCAs can lead to gadolinium deposition in the brain. Methods: We review the literature on gadolinium deposition, including both animal and human studies, as well as the literature on GBCA-associated health outcomes. Additionally, we summarize and discuss the updated medical society recommendations and perspectives on GBCA use in clinical practice. Results: The first publication reporting gadolinium deposition in the human brain was published in 2014. Since that seminal report, multiple studies have demonstrated that exposure to linear GBCAs is associated with gadolinium deposition in the dentate nucleus and globus pallidus as seen on brain MRI. Macrocyclic GBCA exposure has not convincingly been associated with gadolinium deposition evident on brain MRI. Conclusion: Clear evidence demonstrates that GBCAs lead to gadolinium deposition in the brain in a dose-dependent manner; however, only linear GBCAs have been associated with gadolinium deposition visualized on MRI. To date, no evidence links gadolinium deposition with any adverse health outcome. Updated medical society guidelines emphasize the importance of an individualized risk-benefit analysis with each administration of GBCAs.

T₁-Weight Magnetic Resonance Imaging Performances of Iron Oxide Nanoparticles Modified with a Natural Protein Macromolecule and an Artificial Macromolecule

To optimize the iron oxide nanoparticles as T₁-weight contrast for in vivo magnetic resonance imaging (MRI), numbers of macromolecule ligands have been explored with considerable effort. However, reports refer to the comparison of the T₁-weight contrast performances of iron oxide nanoparticles modified with natural and artificial macromolecule ligands are still limited. In this work, we used a typical natural protein macromolecule (bovine serum albumin, BSA) and an artificial macromolecule (poly(acrylic acid)-poly(methacrylic acid), PMAA-PTTM) as surface ligands to fabricate Fe₃O₄-BSA and Fe₃O₄-PMAA-PTTM nanoparticles with similar size and magnetization by the coprecipitation method and compared their MRI performances. In vitro and in vivo experiments revealed that Fe₃O₄-BSA with lower cytotoxicity exhibited higher r₂/r₁ ratio in solution and darkening contrast enhancement for liver and kidney sites of mice under T₁-weight imaging, while Fe₃O₄-PMAA-PTTM displayed much lower r₂/r₁ ratio in solution and brighter contrast enhancement for liver and kidney sites. These remarkably different MRI behaviors demonstrated that the surface ligands play an important role for optimizing the MRI performance of Fe₃O₄ nanoparticles. We expect these results may facilitate the design of macromolecule ligands for developing an iron oxide⁻based T₁-weight contrast agent.

Chemistry of MRI Contrast Agents: Current Challenges and New Frontiers

Tens of millions of contrast-enhanced magnetic resonance imaging (MRI) exams are performed annually around the world. The contrast agents, which improve diagnostic accuracy, are almost exclusively small, hydrophilic gadolinium(III) based chelates. In recent years concerns have arisen surrounding the long-term safety of these compounds, and this has spurred research into alternatives. There has also been a push to develop new molecularly targeted contrast agents or agents that can sense pathological changes in the local environment. This comprehensive review describes the state of the art of clinically approved contrast agents, their mechanism of action, and factors influencing their safety. From there we describe different mechanisms of generating MR image contrast such as relaxation, chemical exchange saturation transfer, and direct detection and the types of molecules that are effective for these purposes. Next we describe efforts to make safer contrast agents either by increasing relaxivity, increasing resistance to metal ion release, or by moving to gadolinium(III)-free alternatives. Finally we survey approaches to make contrast agents more specific for pathology either by direct biochemical targeting or by the design of responsive or activatable contrast agents.

A pentadentate member of the picolinate family for Mn(ii) complexation and an amphiphilic derivative

We report a pentadentate ligand containing a 2,2'-azanediyldiacetic acid moiety functionalized with a picolinate group at the nitrogen atom (H3paada), as well as a lipophylic derivative functionalized with a dodecyloxy group at position 4 of the pyridyl ring (H3C12Opaada). The protonation constants of the paada3- ligand and the stability constant of the Mn(ii) complex were determined using a combination of potentiometric and spectrophotometric titrations (25 °C, 0.15 M NaCl). A detailed relaxometric characterisation was accomplished by recording 1H Nuclear Magnetic Relaxation Dispersion (NMRD) profiles and 17O chemical shifts and relaxation rates. These studies provide detailed information on the microscopic parameters that control their efficiency as relaxation agents in vitro. For the sake of completeness and to facilitate comparison, we also characterised the related [Mn(nta)]- complex (nta = nitrilotriacetate). Both the [Mn(paada)]- and [Mn(nta)]- complexes turned out to contain two inner-sphere water molecules in aqueous solution. The exchange rate of these coordinated water molecules was slower in [Mn(paada)]- (k298ex = 90 × 107 s-1) than in [Mn(nta)]- (k298ex = 280 × 107 s-1). The complexes were also characterised using both DFT (TPSSh/def2-TZVP) and ab initio CAS(5,5) calculations. The lipophylic [Mn(C12Opaada)]- complex forms micelles in solution characterised by a critical micellar concentration (cmc) of 0.31 ± 0.01 mM. This complex also forms a rather strong adduct with Bovine Serum Albumin (BSA) with an association constant of 5.5 × 104 M-1 at 25 °C. The enthalpy and entropy changes obtained for the formation of the adduct indicate that the binding event is driven by hydrophobic interactions.

52g/55Mn-Labelled CDTA-based trimeric complexes as novel bimodal PET/MR probes with high relaxivity

Multimeric trans-1,2-diaminocyclohexane-N,N,N′,N′-tetraacetic acid (CDTA) derivatives labelled with a mixture of paramagnetic ⁵⁵Mn(ii) and β⁺-emitting ^52gMn(ii) offer the access to bimodal Positron Emission Tomography/Magnetic Resonance (PET/MR) tracers.

Reinforced Ni(ii)-cyclam derivatives as dual1H/19F MRI probes

Extremely inert paramagnetic nickel(ii) complexes based on a cross-bridged cyclam platform present responses at the¹H (CEST) and¹⁹F frequencies.

A biocompatible redox MRI probe based on a Mn(ii)/Mn(iii) porphyrin

A water-soluble fluorinated Mn^III/II porphyrin responds reversibly to ascorbate redox state as a turn-on MRI probe.

Synthesis and Evaluation of Manganese(II)-Based Ethylenediaminetetraacetic Acid-Ethoxybenzyl Conjugate as a Highly Stable Hepatobiliary Magnetic Resonance Imaging Contrast Agent

In this study, we designed and synthesized a highly stable manganese (Mn²⁺)-based hepatobiliary complex by tethering an ethoxybenzyl (EOB) moiety with an ethylenediaminetetraacetic acid (EDTA) coordination cage as an alternative to the well-established hepatobiliary gadolinium (Gd³⁺) chelates and evaluated its usage as a T₁ hepatobiliary magnetic resonance imaging (MRI) contrast agent (CA). This new complex exhibits higher r₁ relaxivity (2.3 mM^-1 s^-1) than clinically approved Mn²⁺-based hepatobiliary complex Mn-DPDP (1.6 mM^-1 s^-1) at 1.5 T. Mn-EDTA-EOB shows much higher kinetic inertness than that of clinically approved Gd³⁺-based hepatobiliary MRI CAs, such as Gd-DTPA-EOB and Gd-BOPTA. In addition, in vivo biodistribution and MRI enhancement patterns of this new Mn²⁺ chelate are comparable to those of Gd³⁺-based hepatobiliary MRI CAs. The diagnostic efficacy of the new complex was demonstrated by its enhanced tumor detection sensitivity in a liver cancer model using in vivo MRI.

A discrete organoplatinum(II) metallacage as a multimodality theranostic platform for cancer photochemotherapy

Photodynamic therapy is an effective alternative to traditional treatments due to its minimally invasive nature, negligible systemic toxicity, fewer side effects, and avoidance of drug resistance. However, it is still challenging to design photosensitizers with high singlet oxygen (1O2) quantum yields (QY) due to severe aggregation of the hydrophobic photosensitizers. Herein, we developed a discrete organoplatinum(II) metallacage using therapeutic cis-(PEt3)2Pt(OTf)2 as the building block to improve the 1O2 QY, thus achieving synergistic anticancer efficacy. The metallacage-loaded nanoparticles (MNPs) with tri-modality imaging capability allow precise diagnosis of tumor and real-time monitoring the delivery, biodistribution, and excretion of the MNPs. MNPs exhibited excellent anti-metastatic effect and superior anti-tumor performance against U87MG, drug resistant A2780CIS, and orthotopic tumor models, ablating the tumors without recurrence after a single treatment. Gene chip analyses confirmed the contribution of different therapeutic modalities to the tumor abrogation. This supramolecular platform holds potential in precise cancer theranostics.

Radioactive Transition Metals for Imaging and Therapy

Nuclear medicine is composed of two complementary areas, imaging and therapy. Positron emission tomography (PET) and single-photon imaging, including single-photon emission computed tomography (SPECT), comprise the imaging component of nuclear medicine. These areas are distinct in that they exploit different nuclear decay processes and also different imaging technologies. In PET, images are created from the 511 keV photons produced when the positron emitted by a radionuclide encounters an electron and is annihilated. In contrast, in single-photon imaging, images are created from the γ rays (and occasionally X-rays) directly emitted by the nucleus. Therapeutic nuclear medicine uses particulate radiation such as Auger or conversion electrons or β^- or α particles. All three of these technologies are linked by the requirement that the radionuclide must be attached to a suitable vector that can deliver it to its target. It is imperative that the radionuclide remain attached to the vector before it is delivered to its target as well as after it reaches its target or else the resulting image (or therapeutic outcome) will not reflect the biological process of interest. Radiochemistry is at the core of this process, and radiometals offer radiopharmaceutical chemists a tremendous range of options with which to accomplish these goals. They also offer a wide range of options in terms of radionuclide half-lives and emission properties, providing the ability to carefully match the decay properties with the desired outcome. This Review provides an overview of some of the ways this can be accomplished as well as several historical examples of some of the limitations of earlier metalloradiopharmaceuticals and the ways that new technologies, primarily related to radionuclide production, have provided solutions to these problems.

Manganese-Based Contrast Agents for Magnetic Resonance Imaging of Liver Tumors: Structure-Activity Relationships and Lead Candidate Evaluation

Gd-based MRI contrast agents (GBCAs) have come under intense regulatory scrutiny due to concerns of Gd retention and delayed toxicity. Three GBCAs comprising acyclic Gd chelates, the class of GBCA most prone to Gd release, are no longer marketed in Europe. Of particular concern are the acyclic chelates that remain available for liver scans, where there is an unmet diagnostic need and no replacement technology. To address this concern, we evaluated our previously reported Mn-based MRI contrast agent, Mn-PyC3A, and nine newly synthesized derivatives as liver specific MRI contrast agents. Within this focused library the transient liver uptake and rate of blood clearance are directly correlated with log P. The complex Mn-PyC3A-3-OBn emerged as the lead candidate due to a combination of high relaxivity, rapid blood clearance, and avid hepatocellular uptake. Mn-PyC3A-3-OBn rendered liver tumors conspicuously hypo-intense in a murine model and is wholly eliminated within 24 h of injection.

Melanin-manganese nanoparticles with ultrahigh efficient clearance in vivo for tumor-targeting T1 magnetic resonance imaging contrast agent

Endogenous biomaterials in organisms, with native biocompatibility and biodegradability, appear more advantageous in the development of nanoscale diagnostic and therapeutic systems for future clinical translation. Herein, a novel tumor-targeting Magnetic Resonance Imaging (MRI) contrast agent was developed based on Mn²⁺-chelating ultrasmall water-soluble melanin nanoparticles (MNP-PEG-Mn). The nanoparticles, with a size of about 5.6 nm, presented high chelation stability and showed negligible cytotoxicity as estimated by MTT assay. Moreover, the r₁ longitudinal relaxivity (20.56 mM^-1 s^-1) of MNP-PEG-Mn was much higher than that of Gadodiamide (6.00 mM^-1 s^-1), which is a clinically approved MRI contrast agent. In vivo MRI experiments revealed excellent tumor-targeting specificity after tumor-bearing mice were intravenously injected with MNP-PEG-Mn. Additionally, MNP-PEG-Mn could be excreted via renal and hepatobiliary pathways with negligible toxicity to body tissues. These preliminary results indicated the clinically translatable potential of MNP-PEG-Mn as a T₁ MRI contrast agent for tumor-targeted imaging.

Effect of the Nature of Donor Atoms on the Thermodynamic, Kinetic and Relaxation Properties of Mn(II) Complexes Formed With Some Trisubstituted 12-Membered Macrocyclic Ligands

During the past few years increasing attention has been devoted to Mn(II) complexes as possible substitutes for Gd(III) complexes as contrast agents in MRI. Equilibrium (log KMnL or pMn value), kinetic parameters (rates and half-lives of dissociation) and relaxivity of the Mn(II) complexes formed with 12-membered macrocyclic ligands were studied. The ligands were selected in a way to gain information on how the ligand rigidity, the nature of the donor atoms in the macrocycle (pyridine N, amine N, and etheric O atom), the nature of the pendant arms (carboxylates, phosphonates, primary, secondary and tertiary amides) affect the physicochemical parameters of the Mn(II) complexes. As expected, decreasing the denticity of DOTA (to afford DO3A) resulted in a drop in the stability and inertness of [Mn(DO3A)]- compared to [Mn(DOTA)]2-. This decrease can be compensated partially by incorporating the fourth nitrogen atom into a pyridine ring (e.g., PCTA) or by replacement with an etheric oxygen atom (ODO3A). Moreover, the substitution of primary amides for acetates resulted in a noticeable drop in the stability constant (PC3AMH), but it increased as the primary amides (PC3AMH) were replaced by secondary (PC3AMGly) or tertiary amide (PC3AMPip) pendants. The inertness of the Mn(II) complexes behaved alike as the rates of acid catalyzed dissociation increased going from DOTA (k1 = 0.040 M-1s-1) to DO3A (k1 = 0.45 M-1s-1). However, the rates of acid catalyzed dissociation decreased from 0.112 M-1s-1 observed for the anionic Mn(II) complex of PCTA to 0.0107 M-1s-1 and 0.00458 M-1s-1 for the cationic Mn(II) complexes of PC3AMH and PC3AMPip ligands, respectively. In spite of its lower denticity (as compared to DOTA) the sterically more hindered amide complex ([Mn(PC3AMPip)]2+) displays surprisingly high conditional stability (pMn = 8.86 vs. pMn = 9.74 for [Mn(PCTA)]-) and excellent kinetic inertness. The substitution of phosphonates for the acetate pendant arms (DOTP and DO3P), however, resulted in a noticeable drop in the conditional stability as well as dissociation kinetic parameters of the corresponding Mn(II) complexes ([Mn(DOTP)]6- and [Mn(DO3P)]4-) underlining that the phosphonate pedant should not be considered as a suitable building block for further ligand design while the tertiary amide moiety will likely have some implications in this respect in the future.

A highly stable l-alanine-based mono(aquated) Mn(ii) complex as a T1-weighted MRI contrast agent

The synthesized lithium (S)-6,6'-(1-carboxyethylazanediyl)bis(methylene)dipicolinate (Li₃cbda) is a new chiral, alanine-based ligand bearing two picolinate functionalities. The trianionic form of the ligand [(cbda)^3-] constitutes a seven-coordinate, water-soluble, pentagonal bipyramidal Mn(ii) complex (1). The structural analysis reveals the presence of a water coordinating site in the complex. The complex is thermodynamically very stable, and the stability is not affected by the presence of physiological anions (HCO₃^-, PO₄^3-, and F^-). The pH of the medium exerts a small effect on the stability of the complex. The r₁ relaxivity of 3.02 mM^-1 s^-1 is exhibited by the complex at 1.41 T, pH ∼7.4, and 25 °C. Phantom images obtained via a clinical MRI BRIVO MR355 system established concentration-dependent signal enhancement by the complex. The cytotoxicity test confirmed complex 1 as a biocompatible potential T₁-weighted MRI contrast agent.

Optimising the relaxivities of Mn2+ complexes by targeting human serum albumin (HSA)

We report two novel macrocyclic ligands based on the 1,4-DO2AM platform (1,4-DO2AM = 2,2'-(1,4,7,10-tetraazacyclododecane-1,4-diyl)diacetamide) and containing two benzyl groups attached either to the nitrogen atoms of the macrocyclic unit (1,4-BzDO2AM) or to the amide pendant arms (1,4-DO2AMBz). The protonation constants of the ligands and the stability constants of their Mn²⁺ complexes were determined using pH potentiometry. The introduction of benzyl groups results in a slight decrease of the stability constants of the Mn²⁺ complexes and a slight increase of their acid-catalysed dissociation reactions. A detailed relaxometric characterisation of the complexes using nuclear magnetic dispersion relaxation (NMRD) and ¹⁷O NMR studies indicated that the increase in molecular weight associated with the presence of benzyl groups results in a remarkable increase of proton relaxivities r_1p, which take values of 3.8, 3.5 and 2.5 mM^-1 s^-1 for [Mn(1,4-BzDO2AM)]²⁺, [Mn(1,4-DO2AMBz)]²⁺ and [Mn(1,4-DO2AM)]²⁺ (at 25 °C and 20 MHz). The [Mn(1,4-BzDO2AM)]²⁺ and [Mn(1,4-DO2AMBz)]²⁺ complexes form relatively strong adducts with Human Serum Albumin (HSA) with association constants of (3.9 ± 0.6) × 10³ and (2.0 ± 0.3) × 10³ M^-1, respectively. The interaction with the protein slows down the rotational tumbling of the complex in solution, which results in adducts endowed with remarkably high proton relaxivities (r_1p^b = 18.5 ± 0.7 and 27.4 ± 1.4 mM^-1 s^-1 for [Mn(1,4-BzDO2AM)]²⁺ and [Mn(1,4-DO2AMBz)]²⁺, respectively).

MRI Contrast Agents Based on Conjugated Polyelectrolytes and Dendritic Polymers

Three complexes of gadolinium-based on dentritic molecules are reported as magnetic resonance imaging (MRI) contrast agents. Their ligands feature four carboxylate groups, which contribute to good water solubility and a strong combination with metal ions. As a new attempt, coupling polymerization is carried out to make a combination of conjugated polyelectrolytes and dendrimers for MRI contrast agents. For comparison, mononuclear and binuclear complexes are also reported. The investigation suggests that the contrast agent with the newly designed macromolecular skeleton provides higher longitudinal relaxivity value (36.2 mm -1 s-1 ) and more visible enhancement in in vivo and in vitro MR images than the small molecular ones. In addition, extremely low cytotoxicity and main clearance via hepatobiliary are confirmed, which reduces the deterioration of chronic kidney disease. All the results indicate that these three complexes are generally applicable as promising clinical contrast agents.

A rapid T1 mapping method for assessment of murine kidney viability using dynamic manganese-enhanced magnetic resonance imaging

PURPOSE

Dynamic manganese-enhanced MRI (MEMRI) allows assessment of tissue viability by tracing manganese uptake. We aimed to develop a rapid T1 mapping method for dynamic MEMRI to facilitate assessments of murine kidney viability.

METHODS

A multi-slice saturation recovery fast spin echo (MSRFSE) was developed, validated, and subsequently applied in dynamic MEMRI at 16.4T on ischemic mouse kidneys after 4 weeks of unilateral renal artery stenosis (RAS). Baseline T1 values and post-contrast R1 (1/T1 ) changes were measured in cortex (CO), outer (OSOM), inner (ISOM) strips of outer medulla, and inner medulla (IM).

RESULTS

Validation studies showed strong agreement between MSRFSE and an established saturation recovery Look-Locker method. Baseline T1 (s) increased in the stenotic kidney CO (2.10 [1.95-2.56] vs. 1.88 [1.81-2.00], P = 0.0317) and OSOM (2.17 [2.05-2.33] vs. 1.96 [1.87-2.00], P = 0.0075) but remained unchanged in ISOM and IM. This method allowed a temporal resolution of 1.43 min in dynamic MEMRI. Mn2+ uptake and retention decreased in stenotic kidneys, particularly in the OSOM (ΔR1 : 0.48 [0.38-0.56] vs. 0.64 [0.61-0.69] s-1 , P < 0.0001).

CONCLUSION

Dynamic MEMRI by MSRFSE detected decreased cellular viability and discerned the regional responses to RAS. This technique may provide a valuable tool for noninvasive evaluation of renal viability. Magn Reson Med 80:190-199, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

VSION as high field MRI T1 contrast agent: evidence of their potential as positive contrast agent for magnetic resonance angiography

Because of their outstanding magnetic properties, iron oxide nanoparticles have already been the subject of numerous studies in the biomedical field, in particular as a negative contrast agent for T₂-weighted nuclear magnetic resonance imaging, or as therapeutic agents in hyperthermia experiments. Recent studies have shown that below a given particle size (i.e. 5 nm), iron oxide may be used to provide a significant positive (brightening) effect on T₁-weighted MRI. In such an application, not only the size of the crystal, but also the control of the coating process is essential to ensure optimal properties, especially at a very high field (> 3 T). In this work, we focused on the development of very small iron oxide nanoparticles as a potential platform for high field T₁ magnetic resonance angiography (MRA) applications. The feasibility has been evaluated in vivo at 9.4 T, demonstrating the usefulness of the developed system for MRA applications.

Probing the brain with molecular fMRI

One of the greatest challenges of modern neuroscience is to incorporate our growing knowledge of molecular and cellular-scale physiology into integrated, organismic-scale models of brain function in behavior and cognition. Molecular-level functional magnetic resonance imaging (molecular fMRI) is a new technology that can help bridge these scales by mapping defined microscopic phenomena over large, optically inaccessible regions of the living brain. In this review, we explain how MRI-detectable imaging probes can be used to sensitize noninvasive imaging to mechanistically significant components of neural processing. We discuss how a combination of innovative probe design, advanced imaging methods, and strategies for brain delivery can make molecular fMRI an increasingly successful approach for spatiotemporally resolved studies of diverse neural phenomena, perhaps eventually in people.

Core-shell TaOx@MnO2 nanoparticles as a nano-radiosensitizer for effective cancer radiotherapy

Improving tumor oxygenation and concentrating X-ray radiation energy inside the tumor have received considerable attention in cancer radiotherapy. Herein, core-shell tantalum oxide@manganese dioxide (TaOx@MnO₂) nanostructures are prepared as an efficient radiosensitizer for enhancing radiotherapy (RT). In these nanostructures, the TaOx core serves as a RT sensitizer that efficiently concentrates X-ray radiation energy inside the tumor, while the MnO₂ shell may trigger the decomposition of endogenous H₂O₂ in the tumor microenvironment (TME) to generate oxygen and overcome hypoxia-associated radiation resistance. In vitro and in vivo experiments demonstrated that the synthesized TaOx@MnO₂-PEG nanostructures could accomplish an excellent synergistic radiotherapy sensitization effect. Furthermore, TaOx@MnO₂-PEG nanoparticles could also serve as promising agents for MR/CT dual-modal imaging. In brief, our study highlights a new type of multifunctional radiosensitizer agent to enhance radiotherapy treatment by means of simultaneously concentrating radiation energy inside tumors and overcoming tumor hypoxia, promising for applications in tumor radiotherapy.

Gadolinium-Free Contrast Agents for Magnetic Resonance Imaging of the Central Nervous System

We discuss how the recent revelation that gadolinium (Gd) from commercially available MRI contrast agents is irreversibly and cumulatively deposited in the central nervous system is driving innovation toward Gd-free contrast agents for neuroradiology.

A Magnetofluorescent Carbon Dot Assembly as an Acidic H2 O2 -Driven Oxygenerator to Regulate Tumor Hypoxia for Simultaneous Bimodal Imaging and Enhanced Photodynamic Therapy

Recent studies indicate that carbon dots (CDs) can efficiently generate singlet oxygen (¹ O₂ ) for photodynamic therapy (PDT) of cancer. However, the hypoxic tumor microenvironment and rapid consumption of oxygen in the PDT process will severely limit therapeutic effects of CDs due to the oxygen-dependent PDT. Thus, it is becoming particularly important to develop a novel CD as an in situ tumor oxygenerator for overcoming hypoxia and substantially enhancing the PDT efficacy. Herein, for the first time, magnetofluorescent Mn-CDs are successfully prepared using manganese(II) phthalocyanine as a precursor. After cooperative self-assembly with DSPE-PEG, the obtained Mn-CD assembly can be applied as a smart contrast agent for both near-infrared fluorescence (FL) (maximum peak at 745 nm) and T₁ -weighted magnetic resonance (MR) (relaxivity value of 6.97 mM^-1 s^-1 ) imaging. More interestingly, the Mn-CD assembly can not only effectively produce ¹ O₂ (quantum yield of 0.40) but also highly catalyze H₂ O₂ to generate oxygen. These collective properties of the Mn-CD assembly enable it to be utilized as an acidic H₂ O₂ -driven oxygenerator to increase the oxygen concentration in hypoxic solid tumors for simultaneous bimodal FL/MR imaging and enhanced PDT. This work explores a new biomedical use of CDs and provides a versatile carbon nanomaterial candidate for multifunctional nanotheranostic applications.

Developing the family of picolinate ligands for Mn2+ complexation

We have reported here a series of ligands containing pentadentate 6,6'-(azanediylbis(methylene))dipicolinic acid units that differ in the substituent present at the amine nitrogen atom (acetate: H₃DPAAA; phenyl: H₂DPAPhA; dodecyl: H₂DPAC12A; 4-hexylphenyl: H₂DPAC6PhA). The protonation constants of the hexadentate DPAAA^3- and pentadentate DPAPhA^2- ligands and the stability constants of their Mn²⁺ complexes were determined using pH-potentiometry (25 °C, 0.15 M NaCl). The mono-hydrated [Mn(DPAAA)]^- complex (log K_MnL = 13.19(5)) was found to be considerably more stable than the bis-hydrated [Mn(DPAPhA)] analogue (log K_MnL = 9.55(1)). A detailed ¹H and ¹⁷O NMR relaxometric study was carried out to determine the parameters that govern the proton relaxivities of these complexes. The [Mn(DPAC12A)] complex, which contains a dodecyl lipophilic chain, forms micelles in solution characterized by a critical micellar concentration (cmc) of 96(9) μM. The lipophilic [Mn(DPAC6PhA)] and [Mn(DPAC12A)] derivatives form rather strong adducts with Human Serum Albumin (HSA) with association constants of 7.1 ± 0.1 × 10³ and 1.3 ± 0.4 × 10⁵ M^-1, respectively. The X-ray structure of the complex {K(H₂O)₄}{[Mn(DPAAA)(H₂O)]}₂ shows that the Mn²⁺ ion in [Mn(DPAAA)]^- is coordinated to the six donor atoms of the ligand, a coordinated water molecule completing the pentagonal bipyramidal coordination environment.

Bioinspired, Manganese-Chelated Alginate-Polydopamine Nanomaterials for Efficient in Vivo T1-Weighted Magnetic Resonance Imaging

Manganese-based nanomaterials are an emerging new class of magnetic resonance imaging (MRI) contrast agents (CAs) that provide impressive contrast abilities. MRI CAs that can respond to pathophysiological parameters such as pH or redox potential are also highly in demand for MRI-guided tumor diagnosis. Until now, synthesizing nanomaterials with good biocompatibility, physiochemical stability, and good contrast effects remains a challenge. This study investigated two new systems of calcium/manganese cations complexed with either alginate-polydopamine or alginate-dopamine nanogels [AlgPDA(Ca/Mn) NG or AlgDA(Ca/Mn) NG]. Under such systems, Ca cations form ionic interactions via carboxylic acids of the Alg backbone to enhance the stability of the synthetic nanogels (NGs). Likewise, complexation of Mn cations also increased the colloidal stability of the synthetic NGs. The magnetic property of the prepared CAs was confirmed with superconducting quantum interference device measurements, proving the potential paramagnetic property. Hence, the T₁ relaxivity measurement showed that PDA-complexed synthetic NGs reveal a strong positive contrast enhancement with r₁ = 12.54 mM^-1·s^-1 in 7.0 T MRI images, whereas DA-complexed synthetic NGs showed a relatively lower T₁ relaxivity effect with r₁ = 10.13 mM^-1·s^-1. In addition, both the synthetic NGs exhibit negligible cytotoxicity with >92% cell viability up to 0.25 mM concentration, when incubated with the mouse macrophage (RAW 264.7) and HeLa cells, and high biocompatibility under in vivo analysis. The in vivo MRI test indicates that the synthetic NG exhibits a high signal-to-noise ratio for longer hours, which provides a longer image acquisition time for tumor and anatomical imaging. Furthermore, T₁-weighted MRI results revealed that PEGylated AlgPDA(Ca/Mn) NGs significantly enhanced the signals from liver and tumor tissues. Therefore, owing to the enhanced permeability and retention effect, significantly enhanced in vitro and in vivo imagings, low cost, and one-pot synthesis method, the Mn-based biomimetic approach used in this study provides a promising and competitive alternative for noninvasive tumor detection and comprehensive anatomical diagnosis.

Mn2+ complexes of open-chain ligands with a pyridine backbone: less donor atoms lead to higher kinetic inertness

The loss of a coordinating donor atom in the ligand leads to lower thermodynamic stability, but higher kinetic inertness of Mn²⁺ complexes.

Taking the next step toward inert Mn2+ complexes of open-chain ligands: the case of the rigid PhDTA ligand

Equilibrium, dissociation kinetics, relaxometric and electrochemical properties of the [Mn(PhDTA)]²⁻ complex were investigated and the structure of the [Mn(PhDTA)]²⁻ complex was studied by using DFT calculations.

MRI relaxivity enhancement of gadolinium oxide nanoshells with a controllable shell thickness

The relaxation enhancement mechanism and MRI application of the designed core–shelled silica–Gd₂O₃ nanoparticle contrast agents were studied.

Transition Metal Doping Reveals Link between Electron T1 Reduction and 13C Dynamic Nuclear Polarization Efficiency

Optimal efficiency of dissolution dynamic nuclear polarization (DNP) is essential to provide the required high sensitivity enhancements for in vitro and in vivo hyperpolarized 13C nuclear magnetic resonance (NMR) spectroscopy and imaging (MRI). At the nexus of the DNP process are the free electrons, which provide the high spin alignment that is transferred to the nuclear spins. Without changing DNP instrumental conditions, one way to improve 13C DNP efficiency is by adding trace amounts of paramagnetic additives such as lanthanide (e.g., Gd3+, Ho3+, Dy3+, Tb3+) complexes to the DNP sample, which has been observed to increase solid-state 13C DNP signals by 100-250%. Herein, we have investigated the effects of paramagnetic transition metal complex R-NOTA (R = Mn2+, Cu2+, Co2+) doping on the efficiency of 13C DNP using trityl OX063 as the polarizing agent. Our DNP results at 3.35 T and 1.2 K show that doping the 13C sample with 3 mM Mn2+-NOTA led to a substantial improvement of the solid-state 13C DNP signal by a factor of nearly 3. However, the other transition metal complexes Cu2+-NOTA and Co2+-NOTA complexes, despite their paramagnetic nature, had essentially no impact on solid-state 13C DNP enhancement. W-band electron paramagnetic resonance (EPR) measurements reveal that the trityl OX063 electron T1 was significantly reduced in Mn2+-doped samples but not in Cu2+- and Co2+-doped DNP samples. This work demonstrates, for the first time, that not all paramagnetic additives are beneficial to DNP. In particular, our work provides a direct evidence that electron T1 reduction of the polarizing agent by a paramagnetic additive is an essential requirement for the improvement seen in solid-state 13C DNP signal.

Quantitative comparison of delayed ferumoxytol T1 enhancement with immediate gadoteridol enhancement in high grade gliomas

PURPOSE

Delayed ferumoxytol enhancement on T₁ -weighted images appears visually similar to gadoteridol enhancement. The purpose of this study was to quantitatively compare ferumoxytol T₁ enhancement to gadoteridol enhancement with an objective, semi-automated method.

METHODS

206 sets of post-gadoteridol and 24 h post-ferumoxytol T₁ -weighted scans from 58 high grade glioma patients were analyzed (9 pre-chemoradiation, 111 < 90 days post-chemoradiation, 21 > 90 days post-chemoradiation, 65 post-bevacizumab scans). Enhancement volumes and signal intensities normalized to normal appearing tissue proximal to enhancement were calculated with a semi-automated method. Enhancement cube root volumes (D) and signal intensities (SI) were compared between the 2 contrast agents, and relative difference of D and SI were compared in different treatment groups with multivariate analysis. Within patient differences in D and SI before and after treatment with bevacizumab or steroid were assessed in 26 patients in each treatment group.

RESULTS

When compared to gadoteridol, ferumoxytol D was 13.83% smaller and SI was 7.24% lower (P < 0.0001). The relative differences in D and SI between the 2 contrast agents were not significantly different between treatment groups (P > 0.05). Relative difference in D and SI did not change significantly in response to bevacizumab (P = 0.5234 and P = 0.2442, respectively) or to steroid (P = 0.3774, P = 0.0741) in the within patient comparison.

CONCLUSION

The correlation between the 2 contrast agents' enhancement size and signal intensity and their similar behavior in response to therapy suggest that ferumoxytol can be used for revealing enhancement in high grade glioma patients. Magn Reson Med 80:224-230, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

A Manganese-based Alternative to Gadolinium: Contrast-enhanced MR Angiography, Excretion, Pharmacokinetics, and Metabolism

Purpose To compare intravascular contrast enhancement produced by the manganese-based magnetic resonance (MR) imaging contrast agent manganese-N-picolyl-N,N',N'-trans-1,2-cyclohexenediaminetriacetate (Mn-PyC3A) to gadopentetate dimeglumine (Gd-DTPA) and to evaluate the excretion, pharmacokinetics, and metabolism of Mn-PyC3A. Materials and Methods Contrast material-enhanced MR angiography was performed in baboons (Papio anubis; n = 4) by using Mn-PyC3A and Gd-DTPA. Dynamic imaging was performed for 60 minutes following Mn-PyC3A injection to monitor distribution and elimination. Serial blood sampling was performed to quantify manganese and gadolinium plasma clearance by using inductively coupled plasma mass spectrometry and to characterize Mn-PyC3A metabolism by using high-performance liquid chromatography. Intravascular contrast enhancement in the abdominal aorta and brachiocephalic artery was quantified by measuring contrast-to-noise ratios (CNRs) versus muscle at 9 seconds following Mn-PyC3A or Gd-DTPA injection. Plasma pharmacokinetics were modeled with a biexponential function, and data were compared with a paired t test. Results Aorta versus muscle CNR (mean ± standard deviation) with Mn-PyC3A and Gd-DTPA was 476 ± 77 and 538 ± 120, respectively (P = .11). Brachiocephalic artery versus muscle CNR was 524 ± 55 versus 518 ± 140, respectively (P = .95). Mn-PyC3A was eliminated via renal and hepatobiliary excretion with similar pharmacokinetics to Gd-DTPA (area under the curve between 0 and 30 minutes, 20.2 ± 3.1 and 17.0 ± 2.4, respectively; P = .23). High-performance liquid chromatography revealed no evidence of Mn-PyC3A biotransformation. Conclusion Mn-PyC3A enables contrast-enhanced MR angiography with comparable contrast enhancement to gadolinium-based agents and may overcome concerns regarding gadolinium-associated toxicity and retention. ^© RSNA, 2017 Online supplemental material is available for this article.

Peptide-based fibrin-targeting probes for thrombus imaging

The development of new methods to image the onset and progression of thrombosis is an unmet need. Non-invasive molecular imaging techniques targeting specific key structures involved in the formation of thrombosis have demonstrated the ability to detect thrombus in different disease state models and in patients. Due to its high concentration in the thrombus and its essential role in thrombus formation, the detection of fibrin is an attractive strategy for identification of thrombosis. Herein we provide an overview of recent and selected fibrin-targeted probes for molecular imaging of thrombosis by magnetic resonance imaging (MRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), and optical techniques. Emphasis is placed on work that our lab has explored over the last 15 years that has resulted in the progression of the fibrin-binding PET probe [64Cu]FBP8 from preclinical studies into human trials.